<div id="titulo">Agregar Afiliados</div>
<?php echo form_open_multipart('afiliados/save', array('name' => 'estatus','id' => 'commentForm'));?>
	<table class="tablaform" width="100%" border="0">
		
		<tr>
			<td><b>Nombre Firma:</b> </td>
			<td><input type="text" name="nameF" class="required" id="nameF" maxlength="100" size="40" value="<?php echo set_value('nombre') ?>" /><?php echo form_error('name') ?></td>
		</tr>
		
		<tr>
			<td><b>Nombre Contacto:</b> </td>
			<td><input type="text" name="nameC" class="required" id="nameC" maxlength="100" size="40" value="<?php echo set_value('nombre') ?>" /><?php echo form_error('name') ?></td>
		</tr>
		
		<tr>
			<td><b>Telefono:</b> </td>
			<td><input type="text" name="tel" class="required" id="tel" maxlength="100" size="15" value="<?php echo set_value('nombre') ?>" /><?php echo form_error('name') ?></td>
		</tr>
		
		<tr>
			<td><b>Telefono 2:</b> </td>
			<td><input type="text" name="tel2" class="" id="tel2" maxlength="100" size="15" value="<?php echo set_value('nombre') ?>" /><?php echo form_error('name') ?></td>
		</tr>
		
		<tr>
			<td><b>Fax:</b> </td>
			<td><input type="text" name="fax" class="" id="fax" maxlength="100" size="15" value="<?php echo set_value('nombre') ?>" /><?php echo form_error('name') ?></td>
		</tr>
		
		<tr>
			<td><b>Email:</b> </td>
			<td><input type="text" name="email" class="email" maxlength="100" size="15" value="<?php echo set_value('nombre') ?>" /><?php echo form_error('name') ?></td>
		</tr>
		
		<tr>
			<td><b>Web Site:</b> </td>
			<td><input type="text" name="web" class="url" id="url" maxlength="100" size="30" value="<?php echo set_value('nombre') ?>" /><?php echo form_error('name') ?></td>
		</tr>
		
		<tr>
			<td><b>Categoria:</b> </td>
			<td>
			   <select name="categoria">
			       <?php 
			       foreach ($afiliado as $k){
			       	
			       	    echo '<option value="'.$k->getIdCategoria().'">'.$k->getNombreCategoria().'</option>';
			       }
			       ?>
			   
			   </select>
			</td>
		</tr>
		
		<tr>
			<td><b>Provincia:</b> </td>
			<td>
			   <select name="provincia">
			       <?php 
			       foreach ($provincia as $k){
			       	
			       	    echo '<option value="'.$k->GetIdProvincia().'">'.$k->GetNombre().'</option>';
			       }
			       ?>
			   
			   </select>
			</td>
		</tr>
		
		<tr>
			<td><b>Direccion:</b> </td>
			<td><input type="text" name="direccion" class="required" id="fax" maxlength="100" size="70" value="<?php echo set_value('nombre') ?>" /><?php echo form_error('name') ?></td>
		</tr>

		
		
     	<tr><td colspan="2"><hr /></td></tr>
		<tr><td><input type="submit" value="Guardar" /></td>
		 <td><a href="<?php echo site_url().'/afiliados' ?>"><input type="button" value="Atras" align="center"/></a></td>
		</tr>
	</table>
</form>